Provider Demographics
NPI:1417093485
Name:THE PHARMACY AT HAMPTON PLACE
Entity Type:Organization
Organization Name:THE PHARMACY AT HAMPTON PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:256-425-0054
Mailing Address - Street 1:6727 HIGHWAY 431 S
Mailing Address - Street 2:SUITE M
Mailing Address - City:HAMPTON COVE
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9225
Mailing Address - Country:US
Mailing Address - Phone:256-425-0054
Mailing Address - Fax:256-425-0057
Practice Address - Street 1:6727 HIGHWAY 431 S
Practice Address - Street 2:SUITE M
Practice Address - City:HAMPTON COVE
Practice Address - State:AL
Practice Address - Zip Code:35763-9225
Practice Address - Country:US
Practice Address - Phone:256-425-0054
Practice Address - Fax:256-425-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1123113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy